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Dhakal R, Adhikari C, Karki P, Neupane N, Bhandari P, Gurung A, Shrestha N, Gahatraj N, Shrestha N, Koirala N, Subedi G. Attitude sustains longer than subjective norm and perceived behavioral control: Results of breast cancer screening educational intervention. PLoS One 2023; 18:e0281184. [PMID: 36763623 PMCID: PMC9916560 DOI: 10.1371/journal.pone.0281184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 01/17/2023] [Indexed: 02/11/2023] Open
Abstract
Breast malignancy is the most frequent carcinoma among females across the world and third-most in Nepal. Early diagnosis of breast cancer through breast health awareness and self-examination, in addition to mammography screening, is a highly feasible and useful technique in poorly resourced settings. However, their intentions, whether to modify behaviors or actions, remain debatable and less explained in the literature. So, we aimed to assess how long an educational intervention affects women's intention to do a breast self-examination (BSE) and mammography screening. After assessing feasibility, one ward was assigned to the intervention (IG; ward number 30) and control group (CG; ward number 33), and then with inclusion criteria, a total of 360 females (180 each in IG and CG) aged 40-75 years enrolled in the study. After the baseline assessment, participants in the IG were delivered an hour-long breast cancer screening-related lecture-discussion- demonstration session that included BSE and mammography, aided with a silicone dummy. The session was carried out by the female trained nurses. Outcome data were obtained at the baseline, 4, 8, and 12 months following the intervention. Attitudes, perceived behavioral controls (PBCs) and behavioral intents (BIs) of both mammography and BSE at baseline were similar in both IG and CG except in case of subjective norms (SNs). Intents of BSE remained effective for 4 months, whereas for mammography, it was effective only at 4 and 12 months. Moreover, attitudes toward both tests remained intact for 4, 8, and 12 months (p = < .05) consistently. With regards to PBCs, women having good control remained only for 4 months in both screening tests. Further, regarding SN, significant mean changes were observed at 4 and 12 months in BSE, and only at 4 months in mammography screening. The session was effective in sustaining BSE and mammography intentions for at least 4 months. To retain the effects longer (up to 12 months), additional educational strategies focusing on subjective norms and perceived behavioral controls of both tests are highly warranted.
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Affiliation(s)
- Rojana Dhakal
- Department of Nursing, School of Health and Allied Sciences, Pokhara University, Pokhara, Gandaki Province, Nepal
- * E-mail: ,
| | - Chiranjivi Adhikari
- Department of Public Health, School of Health and Allied Sciences, Pokhara University, Pokhara, Gandaki Province, Nepal
- Department of Public Health, Indian Institute of Public Health Gandhinagar (IIPHG), Gandhinagar, Gujarat, India
| | - Prabha Karki
- Department of Nursing, School of Health and Allied Sciences, Pokhara University, Pokhara, Gandaki Province, Nepal
| | - Nirmala Neupane
- Department of Nursing, School of Health and Allied Sciences, Pokhara University, Pokhara, Gandaki Province, Nepal
| | - Pooja Bhandari
- Department of Nursing, School of Health and Allied Sciences, Pokhara University, Pokhara, Gandaki Province, Nepal
| | - Aditi Gurung
- Department of Nursing, School of Health and Allied Sciences, Pokhara University, Pokhara, Gandaki Province, Nepal
| | - Nisha Shrestha
- Department of Nursing, Pokhara Nursing Campus, Institute of Medicine, Tribhuvan University, Pokhara, Gandaki Province, Nepal
| | - Nandaram Gahatraj
- Department of Public Health, School of Health and Allied Sciences, Pokhara University, Pokhara, Gandaki Province, Nepal
| | - Niranjan Shrestha
- Department of Public Health, School of Health and Allied Sciences, Pokhara University, Pokhara, Gandaki Province, Nepal
| | - Niranjan Koirala
- Department of Natural Products Research, Gandaki Province Academy of Science and Technology, Pokhara, Nepal
| | - Govind Subedi
- Central Department of Population Studies, Tribhuvan University, Kritipur, Bagmati Province, Nepal
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Compton MT, Krishan S, Broussard B, Bakeman R, Fleischmann MH, Hankerson-Dyson D, Husbands L, Stewart T, D'Orio B, Del Pozo B, Watson AC. Using the Theory of Planned Behavior to Understand How Crisis Intervention Team (CIT) Training Facilitates Police Officers' Mental Health Referrals. Community Ment Health J 2022; 58:1112-1120. [PMID: 34812962 PMCID: PMC9197601 DOI: 10.1007/s10597-021-00920-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 11/12/2021] [Indexed: 11/27/2022]
Abstract
The Theory of Planned Behavior posits that behaviors are predicted by one's intention to perform them; intention is driven by attitude toward the behavior, subjective norm, and perceived behavioral control. We used this theory to predict Crisis Intervention Team (CIT)-trained and non-CIT officers' intention to facilitate referral of persons with suspected mental illnesses to mental health services. CIT-trained (n = 251) and non-CIT (n = 335) officers from six law enforcement agencies participated. CIT-trained officers had significantly greater scores on all constructs. Theory constructs fit the data well, and fit did not differ meaningfully between the two groups. Direct and indirect predictors together accounted for 28% and 21%, respectively, of variance in behavioral intention. Attitude was the strongest predictor. Intentions to facilitate mental health referrals may be driven by the same factors among CIT-trained and non-CIT officers, but CIT officers, even at a median of 22 months after training, have significantly higher scores on those factors.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 722 W. 168th Street, Room R249, New York, NY, 10032, USA. .,New York State Psychiatric Institute, New York, NY, USA.
| | - Shaily Krishan
- Council of State and Territorial Epidemiologists, Atlanta, GA, USA
| | - Beth Broussard
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Roger Bakeman
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Matthew H Fleischmann
- Department of Educational & Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Dana Hankerson-Dyson
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Letheshia Husbands
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Barbara D'Orio
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Brandon Del Pozo
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Amy C Watson
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Keshavarzi A, Asadi S, Asadollahi A, Mohammadkhah F, Khani Jeihooni A. Tendency to Breast Cancer Screening Among Rural Women in Southern Iran: A Structural Equation Modeling (SEM) Analysis of Theory of Planned Behavior. BREAST CANCER: BASIC AND CLINICAL RESEARCH 2022; 16:11782234221121001. [PMID: 36091183 PMCID: PMC9452820 DOI: 10.1177/11782234221121001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Early detection of breast cancer is a crucial factor in surviving the disease. This study aimed to investigate the mammography screening based on the theory of planned behavior (TPB) among rural women in Fasa and Shiraz cities, Iran. Methods: This study is a cross-sectional study performed on 800 female clients referring to rural health centers in Fasa and Shiraz cities in southern Iran in early 2021. The authors decided to send and distribute the electronic questionnaire form through the WhatsApp application in collaboration with the health staff of rural health centers for the people covered by these centers. Data gathering tools were a questionnaire on demographic characteristics, a questionnaire based on constructs of TPB, and behavior of mammography screening. Using the structural equation model (SEM), the TPB constructs and demographic variables were entered into the model. Data analysis was executed employing SPSS software version 26 and Amos version 24 (IBM Co., Ann Arbor, MI, USA). Analyzing the data was carried out using the 1-way analysis of variance (ANOVA), logistic regression, and structural equation analysis. During data analysis, various model indicators such as the goodness of fit, including comparative fit index (CFI), goodness-of-fit index (GFI), root mean square error of approximation (RMSEA), and chi-square index/df were evaluated. The significance level in all tests was considered 0.05. Results: The knowledge, attitude, and perceived behavioral control were the predictors of intention and behavior of mammography screening among the women. Among demographic variables, age, literacy, being menopausal, cancer in family, city, and ethnicity contribute more to the variance variation in TPB constructs. In this study, 7.2% of Persians, 8% of Qashqai Turks, and 4.5% of Arabs are contemplating going to mammography screening. In total, 6.8% (54 people) of all individuals intended to go mammography screening, and 5.4% (43 people) had a history of mammography screening. Goodness-of-fit indices (χ2 = 18.45, df = 10, n = 800, χ2/df = 1.845, RMSEA = 0.032, GFI = 0.90, non-normed fit index (NNFI) = 0.91) of conceptual model of this study indicate the suitability of the model. Conclusions: The results of the study indicated that the constructs of the TPB can predict mammography screening behaviors in rural women. It has also demonstrated that mammographic behavior can be improved in rural women using education based on the TPB model, emphasizing critical psychological factors of creating or changing behavior.
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Affiliation(s)
- Ameneh Keshavarzi
- Department of Gynecology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Saeedeh Asadi
- Department of Gynecology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Abdolrahim Asadollahi
- Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Mohammadkhah
- Department of Community Health, Child Nursing and Aging, Ramsar School of Nursing, Babol University of Medical Sciences, Babol, Iran
| | - Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Ritchie D, Van den Broucke S, Van Hal G. The health belief model and theory of planned behavior applied to mammography screening: A systematic review and meta-analysis. Public Health Nurs 2020; 38:482-492. [PMID: 33258163 DOI: 10.1111/phn.12842] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) are used to explain screening behavior. Although reviews of each model have been conducted independently, none have compared the application of both to mammography screening. METHODS A systematic review of literature published in five databases from 1974 to 2020 was performed. Meta-analysis of the explanatory value of the HBM and TPB and effect sizes of their cognitive variables was conducted. RESULTS Altogether, 673 papers reporting HBM studies and 577 reporting TPB studies were recovered, of which 43 HBM studies and 15 TPB studies met the eligibility criteria. Twelve studies reported on the explanatory value of either model. The explained variance for HBM ranged from 25% to 89% (mean R2 = .55), while the explained variance for TPB ranged from 16% to 81% (mean R2 = .24 [screening behavior as outcome] and 0.46 [intention as outcome]). The component of "cue to action" had the greatest effect size (mean OR 1.80 [95% CI: 1.58-2.04]). CONCLUSIONS While the HBM and TPB both demonstrated positive explanatory value, most studies examined the individual constructs of each model and failed to report consistently on the effectiveness of the models.
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Affiliation(s)
- David Ritchie
- Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
| | - Stephan Van den Broucke
- Faculty of Psychology and Educational Sciences and the Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Guido Van Hal
- Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
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Khani Jeihooni A, Darvishi N, Harsini PA. The Effect of Educational Intervention Based on the Theory of Planned Behavior on Mammography Screening in Iranian Women. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:264-273. [PMID: 30604386 DOI: 10.1007/s13187-018-1460-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Mammography is the most special screening method for early diagnosis of breast cancer. The purpose of present research is investigating the effect of educational intervention based on theory of planned behavior on mammography screening of women in Fasa city, Fars province, Iran. In this quasi-experimental study, 400 subjects (200 subjects for experimental group and 200 subjects for control group) were selected in 2017-2018. Educational intervention for the experimental group included 8 educational sessions. A questionnaire used for evaluating demographic information and constructs of theory of planned behavior (knowledge, perceived behavioral control, subjective norms, and attitude) investigated mammography performance of women before and 6 months after intervention. Data were analyzed by using SPSS 22 through chi-square test, McNemar's test, and Wilcoxon-Mann-Whitney test at significance level of P < 0.05. The average age of subjects was 45.52 ± 6.76 years in the experimental group and 45.12 ± 6.64 years in the control group. Six months after intervention, the experimental group showed significant increase in knowledge, perceived behavioral control, subjective norms, and attitude compared to the control group and 174 people (78%) of the experimental group had intention for doing mammography and 148 people (74%) of the experimental group performed mammography. Also, 6 months after educational intervention, 38 people (19%) of the control group had intention for performing mammography and 14 people (7%) of the control group performed mammography.
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Affiliation(s)
- Ali Khani Jeihooni
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran.
- Fasa Ibn Sina square, Fasa University of Medical Sciences, Fasa, P.Code:7461686688, Iran.
| | - Niloofar Darvishi
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Pooyan Afzali Harsini
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Mirzaei-Alavijeh M, Ghorbani P, Jalilian F. Socio-Cognitive Determinants of the Mammography Screening Uptake among Iranian Women. Asian Pac J Cancer Prev 2018; 19:1351-1355. [PMID: 29802699 PMCID: PMC6031812 DOI: 10.22034/apjcp.2018.19.5.1351] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background: Mammography screening uptake is the most effective method in breast cancer screening. The aim
of this study was to determine the determinants related to mammography screening uptake among Iranian women
based on the theory of planned behavior. Materials and Methods: This cross-sectional study was conducted among
408 women who referred to health centers in Kermanshah city, the western of Iran, during 2016. Participants filled
out a self-administered questionnaire. Data were analyzed by SPSS version 21 using Pearson correlation, linear and
logistic regression statistical tests at 95% significant level. Results: The mean age of participants was 39.61 years
[SD: 8.28], ranged from 30 to 60 years. Almost 13% of the participants had already mammography screening uptake
at least once. Perceived behavioral control (OR=1.229) and behavioral intention (OR=1.283) were the more influential
predictors on mammography screening uptake. Conclusions: Based on result, it seems increase perceived behavior
control toward mammography screening uptake may be usefulness in promotion of mammography screening uptake
among Iranian women.
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Affiliation(s)
- Mehdi Mirzaei-Alavijeh
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Predicting women's intentions for contralateral prophylactic mastectomy: An application of an extended theory of planned behaviour. Eur J Oncol Nurs 2016; 21:57-65. [DOI: 10.1016/j.ejon.2015.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 11/14/2015] [Accepted: 12/07/2015] [Indexed: 11/23/2022]
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Abstract
AIMS To identify the current status of theory evaluation in nursing and provide directions for theory evaluation for future development of theoretical bases of nursing discipline. BACKGROUND Theory evaluation is an essential component in development of nursing knowledge, which is a critical element in development of nursing discipline. Despite earlier significant efforts for theory evaluation in nursing, a recent decline in the number of theory evaluation articles was noted and there have been few updates on theory evaluation in nursing. DESIGN Discussion paper. DATA SOURCES A total of 58 articles published from 2003-2014 were retrieved through searches using the PUBMED, PsyInfo and CINAHL. The articles were sorted by the area of evaluation and analysed to identify themes reflecting the theory evaluation process. IMPLICATIONS FOR NURSING Diverse ways of theory evaluation need to be continuously used in future theory evaluation efforts. CONCLUSION Six themes reflecting the theory evaluation process were identified: (a) rarely using existing theory evaluation criteria; (b) evaluating specifics; (c) using various statistical analysis methods; (d) developing instruments; (e) adopting in practice and education; and (f) evaluating mainly middle-range theories and situation-specific theories.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Differences in knowledge, attitudes, beliefs, and perceived risks regarding colorectal cancer screening among Chinese, Korean, and Vietnamese sub-groups. J Community Health 2014; 39:248-65. [PMID: 24142376 DOI: 10.1007/s10900-013-9776-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Asian ethnic subgroups are often treated as a single demographic group in studies looking at cancer screening and health disparities. To evaluate knowledge and health beliefs associated with colorectal cancer (CRC) and CRC screening among Chinese, Korean, and Vietnamese subgroups, a survey assessed participants' demographic characteristics, healthcare utilization, knowledge, beliefs, attitudes associated with CRC and CRC screening. Exploratory factor analysis identified six factors accounting >60 % of the total variance in beliefs and attitudes. Cronbach's alpha coefficients assessed internal consistency. Differences among Asian subgroups were assessed using a Chi square, Fisher's exact, or Kruskal-Wallis test. Pearson's correlation coefficient assessed an association among factors. 654 participants enrolled: 238 Chinese, 217 Korean, and 199 Vietnamese. Statistically significant differences existed in demographic and health care provider characteristics, knowledge, and attitude/belief variables regarding CRC. These included knowledge of CRC screening modalities, reluctance to discuss cancer, belief that cancer is preventable by diet and lifestyle, and intention to undergo CRC screening. Chinese subjects were more likely to use Eastern medicine (52 % Chinese, 25 % Korean, 27 % Vietnamese; p < 0.001); Korean subjects were less likely to see herbs as a form of cancer prevention (34 % Chinese, 20 % Korean, 35 % Vietnamese; p < 0.001). Vietnamese subjects were less likely to consider CRC screening (95 % Chinese, 95 % Korean, 80 % Vietnamese; p < 0.0001). Important differences exist in knowledge, attitudes, and health beliefs among Asian subgroups. Understanding these differences will enable clinicians to deliver tailored, effective health messages to improve CRC screening and other health behaviors.
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Tolma EL, Stoner JA, Li J, Kim Y, Engelman KK. Predictors of regular mammography use among American Indian women in Oklahoma: a cross-sectional study. BMC WOMENS HEALTH 2014; 14:101. [PMID: 25169207 PMCID: PMC4237829 DOI: 10.1186/1472-6874-14-101] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 08/18/2014] [Indexed: 11/25/2022]
Abstract
Background There are significant disparities in breast cancer screening and survivorship between American Indian (AI) and non-Hispanic white women. This study aimed to identify the salient beliefs AI women from Oklahoma have on regular mammography screening, and to determine which beliefs and health- related practices are associated with past mammography screening behavior. Methods This study used an integrated model of the Theory of Planned Behavior as the guiding theoretical framework. Data were collected from 255 (mean age = 51 years, SD 7.64 years) AI women randomly selected from a rural Oklahoma medical clinic (response rate: 79%). Multivariate logistic regression was used to identify factors associated with self-reported past mammography within the last two years while controlling for demographic variables. Associations were summarized using odds ratios (OR), the ratio of the odds of past mammography per a 1-unit increase in continuous independent factor scales (subjective physician norm, cultural affiliation, fatalism, knowledge of mammography screening guidelines, and perceived behavior control barriers) or between groups defined by categorical variables, and 95% confidence intervals (CI). Results Of the participants, 65% (n = 167) reported a screening mammogram within the last two years. After adjustment for age and educational status, women with a higher total subjective-norm physician score (OR = 1.15, 95% CI: 1.06-1.24), a higher knowledge of mammography screening guidelines (OR = 1.52, 95% CI: 1.00-2.31), a family history of breast cancer (OR = 9.97, 95% CI: 3.05-32.62), or reporting an annual versus none or a single physician breast examination (OR = 5.57, 95% CI: 1.79-17.37) had a higher odds of past mammography. On the other hand, women who were more culturally affiliated (OR = 0.42, 95% CI: 0.24-0.74), perceived more barriers (OR = 0.86, 0.78-0.94), or had higher fatalistic attitudes toward breast cancer (OR = 0.90, 95% CI: 0.82-0.99) had lower odds of past mammography. Conclusion In the development of culturally-appropriate interventions promoting mammography among AI communities, emphasis could be put on the following: a) promoting clinic-related practices (e.g. physician recommendation, physician breast examination); b) promoting community-related practices (e.g. knowledge about mammography while eliminating fatalistic attitudes); and c) reducing environmental barriers.
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Affiliation(s)
- Eleni L Tolma
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, CHB Rm, 473, P,O, Box 26901, 73126 Oklahoma City, OK, USA.
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Abstract
Cancer survivors are at risk for recurrences, new cancers, and late and long-term effects of cancer treatments. Health promotion and management of comorbid conditions remain a standard of care for cancer survivors. Nurse practitioners should collaborate with oncology specialists using a shared-care model in delivering survivorship care.
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Tolma E, Batterton C, Hamm RM, Thompson D, Engelman KK. American Indian Women and Screening Mammography. AMERICAN JOURNAL OF HEALTH EDUCATION 2013. [DOI: 10.1080/19325037.2012.10599214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Eleni Tolma
- a Department of Health Promotion Sciences , University of Oklahoma Health Sciences Center , Oklahoma City , OK , 73190
| | - Chasity Batterton
- b Department of Health Administration and Policy College of Public Health , University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma , 73190
| | - Robert M. Hamm
- c Department of Family and Preventive Medicine , University of Oklahoma Health Sciences Center , Oklahoma City , OK , 73104
| | - David Thompson
- d Department of Biostatistics and Epidemiology, College of Public Health , University of Oklahoma Health Science Center , Oklahoma City , Oklahoma , 73190
| | - Kimberly K. Engelman
- e Department of Preventive Medicine and Public Health , University of Kansas School of Medicine , Kansas City , KS , 66160
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Griva F, Anagnostopoulos F, Madoglou S. Mammography screening and the theory of planned behavior: suggestions toward an extended model of prediction. Women Health 2010; 49:662-81. [PMID: 20183107 DOI: 10.1080/03630240903496010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Mammography screening is probably the most effective method for the early detection of breast cancer. Existing models of health behavior, such as the theory of planned behavior, could improve their predictive validity and, therefore, their ability to promote health-related interventions by identifying additional factors associated with health decision making. This review provides an overview of research on factors related to mammography screening within the context of the theory of planned behavior and identifies the potential benefits of adding motivational factors, such as time perspective, optimism, and risk perception, in an attempt to enhance its explanatory power.
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Affiliation(s)
- Fay Griva
- Department of Psychology, Panteion University, Athens, Greece
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Pasick RJ, Barker JC, Otero-Sabogal R, Burke NJ, Joseph G, Guerra C. Intention, subjective norms, and cancer screening in the context of relational culture. HEALTH EDUCATION & BEHAVIOR 2010; 36:91S-110S. [PMID: 19805793 DOI: 10.1177/1090198109338919] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research targeting disparities in breast cancer detection has mainly utilized theories that do not account for social context and culture. Most mammography promotion studies have used a conceptual framework centered in the cognitive constructs of intention (commonly regarded as the most important determinant of screening behavior), self-efficacy, perceived benefit, perceived susceptibility, and/or subjective norms. The meaning and applicability of these constructs in diverse communities are unknown. The purpose of this study is to inductively explore the social context of Filipina and Latina women (the sociocultural forces that shape people's day-to-day experiences and that directly and indirectly affect health and behavior) to better understand mammography screening behavior. One powerful aspect of social context that emerged from the findings was relational culture, the processes of interdependence and interconnectedness among individuals and groups and the prioritization of these connections above virtually all else. The authors examine the appropriateness of subjective norms and intentions in the context of relational culture and identify inconsistencies that suggest varied meanings from those intended by behavioral theorists.
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Affiliation(s)
- Rena J Pasick
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA 94158-9001, USA.
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Baron-Epel O. Attitudes and Beliefs Associated With Mammography in a Multiethnic Population in Israel. HEALTH EDUCATION & BEHAVIOR 2009; 37:227-42. [DOI: 10.1177/1090198109339460] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article highlights beliefs, attitudes, and barriers that are associated with mammography use in four distinct cultural and ethnic groups in Israel: veteran, ultra-orthodox, and immigrant Jewish and Arab women. A random telephone survey of 1,550 women was performed. Information from claims records concerning mammography use was obtained for each woman from Maccabi Health Services. Of the barriers studied, no one barrier was associated with mammography performance in all population groups. However, the combined measure was associated with mammography use in all groups. Subjective norms, fatalism, fear of breast cancer, and perceived effectiveness were associated with mammography in some of the population groups but not in others. Each population seems to have a unique set of variables predicting mammography use. It is not possible to generalize from one population to another and it implies that information concerning beliefs and attitudes should be studied in each subpopulation before planning interventions.
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Son HK, Kam S, Park KS, Kim JR, Kim RB, Park SK. The Factors Associated with Changes in the Stage of Breast Cancer Screening Behavior among the Woman who are Eligible for the Korean National Cancer Screening Program. J Prev Med Public Health 2009; 42:109-16. [DOI: 10.3961/jpmph.2009.42.2.109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Hyo-Kyung Son
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Korea
| | - Sin Kam
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Korea
| | - Ki-Soo Park
- Department of Preventive Medicine, School of Medicine and Institute of Health Sciences, Gyeongsang National University, Korea
| | - Jang-Rak Kim
- Department of Preventive Medicine, School of Medicine and Institute of Health Sciences, Gyeongsang National University, Korea
| | - Rock-Bum Kim
- Department of Preventive Medicine, School of Medicine and Institute of Health Sciences, Gyeongsang National University, Korea
| | - Sun-Kyun Park
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Korea
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Abstract
This article reviews the contribution and potential of widely used health behavior theories in research designed to understand and redress the disproportionate burden of breast cancer borne by diverse race/ethnic, immigrant, and low-income groups associated with unequal use of mammography. We review the strengths and limitations of widely used theories and the extent to which theory contributes to the understanding of screening disparities and informs effective intervention. The dominant focus of most theories on individual cognition is critically assessed as the abstraction of behavior from its social context. Proposed alternatives emphasize multilevel ecological approaches and the use of anthropologic theory and methods for more culturally grounded understandings of screening behavior. Common and alternative treatments of fatalism exemplify this approach, and descriptive and intervention research exemplars further highlight the integration of screening behavior and sociocultural context.
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Affiliation(s)
- Rena J Pasick
- Comprehensive Cancer Center, University of California, San Francisco, CA 94143-0981, USA.
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18
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Abstract
BACKGROUND Supportive care during childbirth is as old as humankind and has been a cornerstone of intrapartum practice for decades. Researchers have postulated that supportive care during labor leads to positive outcomes by enhancing normal labor physiology and the mother's childbirth experience. Questions, however, have risen about the ability of intrapartum nurses to provide effective supportive care within today's medicalized hospital birth environment. OBJECTIVES The aims of this study were to examine the contribution of attitudinal, normative, and control influences on intrapartum nurses' intentions to provide professional labor support (PLS) to parturient women and to assess if behavioral intent could predict the outcome of length of labor. METHODS A retrospective exploratory study was used to survey 39 registered nurses and 419 nurse-patient dyads to understand the relationship between predictor variables, behavioral intention, and health outcomes. Multiple regression analysis was used for statistical analysis. RESULTS The Theory of Planned Behavior (TPB) explained 70% of the variance in intrapartum nurses' intentions to provide PLS to their patients. Behavioral intent (beta = -.08, rho =.677) had no statistically significant impact on a patient's length of labor. DISCUSSION Both attitude and social pressures had a significant impact on the intention to perform PLS, and results show the relative importance of these variables in understanding the nurse's intention to provide support. Although behavioral intent had no significant influence on behavior, as measured by the patient's length of labor, clinical significance needs to be addressed. The regression correlation suggested that as the behavioral intent scores increased, length of labor decreased in the nurse's parturient population. Further studies are required to determine if the TPB can predict health outcomes through nurses' intentions to provide care.
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Affiliation(s)
- Donna J Sauls
- College of Nursing, Texas Woman's University, Denton, Texas 76204, USA.
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